January 6th, 2010


Prescription Drug cost absurdities

There are an awful lot of things wrong with the medical care system in the US, some of which may be repaired by Congress this year. One of the oddest things is the variation of prices for drugs. In the AARP magazine they published the following data for the purchase of 30 days of 80 mg Simvastatin (an anti-cholesterol drug - a pretty high dose at that) somewhere in CA:

$7.71 at Costco
$24.36 at WalMart
$63.59 at CVS
$89.99 at Walgreens

Also $145-$213 for Zocor - same drug - but since the patent ran out several years ago it is available in generic form.

What other kind of products are there with such price variability? The Walgreens price was almost 12 times the Costco price.

To add to this mess there are several other "statins" that are not available in Generic form and some are even more expensive. There is little clinical evidence that any one is better than another or that any have more or fewer possible side-effects although for some people it may well make a difference.

What people or their insurance pay is a whole other piece of confusion to this can of worms.

A sad case of alcoholism

Here's a sad tale of an alcoholic. Those of you in the Boston area may have been reading about this. Anthony Gallucio, my state senator (he just resigned), was sentenced to a year in jail for violating probation.

His probation had confined him to home for 4 months remaining alcohol free but when a daily testing device was installed he tested positive. He first blamed it on the sorbitol in his toothpaste. Expert witnesses didn't help him in his hearing on Monday.

This probation was because of a hit-and-run case where he was caught because among other things his license plate made an imprint on the car he hit. He was presumably drunk and fled because he didn't want that to be discovered. It was revealed that 12 hours before he had showed up on foot at a gas station too drunk to drive and a cop drove him home (difficult because he had forgotten where he lived).

He had three DUIs as priors but was pardoned once and another case dismissed because of lack of evidence. The hit-and-run did injure a passenger; the prior accidents apparently didn't injure anyone. There is no doubt that he has received some favorable treatment by members of the police force, perhaps the courts, and his pardon was by once-Governor Weld (who had campaigned on a theme that prisoners should be crushing rocks).

Prior to being State Senator he was State Rep and before that he was a Cambridge City Councillor and served as Mayor for one term as well.

I've seen him in action and talked to him a few times. I haven't always agreed with his positions but in one-on-one discussions he listened to the opposing points and responded rationally and articulately. He is a smart guy and is extremely passionate about what he believes in. (Some people think he sometimes poured oil on troubled waters that he created so as to get credit). He devoted lots of effort to helping mostly-troubled youths get better lives through legislation, programs, and personal intervention. I suspect that there are a bunch of young adults now living productive lives that might well have been in jail or be dead without some aspects of Anthony's help.

The Boston Globe editorial today said that this whole saga was a good example of friends, fellow politicians, constituents, and law enforcement official's attempts to help him actually harming him. I think his letter of resignation yesterday was the first time he admitted publicly that he was an alcoholic.

It will be interesting to see what happens to him in the future. Can he conquer his addiction and resurrect a career?